Clinical Evaluation of MR Venography for the Deep Venous Thrombosis

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  • 下肢深部静脈血栓症におけるMR venographyの有用性の検討

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<p>Thirty-nine patients with suspected deep venous thrombosis underwent 2D-TOF MR venography (MRV) using 1.5 T super-conducting MR systems with body coils. Scan parameters were as follows: SPGR (TR=35, TE=6.7ms, FA=45 deg) or FLASH (TR=30, TE=9ms, FA=45 deg). MIP post processing was performed to yield angiographic images. In 31 cases, stenoses or occlusions of the deep veins of the lower extremities were demonstrated on MRV. In addition, dilated collateral vessels or great saphenous veins were also noticed. In the other 8 cases, symptoms were soon improved and the diagnosis of DVT were not ensured. In the pelvis and thigh, MRV was superior to conventional venography in demonstrating deep veins and also stenoses or occlusions of deep veins. In 2 cases, follow-up MRV examinations after conservative therapy with a relief of symptoms showed marked improvement of stenosis. However, MRV sometimes failed to delineate small vessels in the lower legs. MRV with tourniquet or leg-warming might improve demonstraion of the lower leg veins. But, even with these techniques, demonstration of lower leg veins was not good enough. Therefore, contrast-enhanced MRV of the lower legs combined with 2D-TOF MRV from the pelvis through knee is recommended. One of great advantages of contrast-enhanced MRV is the possibility of direct imaging of thrombus in the lumen on non-enhanced original source images.</p><p>MRV is a non or less-invasive modality in demonstrating deep venous thrombosis. It should be performed before conventional venography and would be more widely used in the evaluation of the deep venous thrombosis.</p>

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